Your physician may be thinking about suicide

by Heather Fork, MD

Very few of us are untouched by the tragedy of suicide. Whether in our own family, through friends, or one of our colleagues, most of us have been affected by suicide.   We are often left alone, with the painful questions,

“Why?”

“What could we have done differently?”

Now we learn from a study by Shanafelt et. al, in the Achieves of Surgery, that one in 16 surgeons had suicidal ideations in the previous year. Yet only 26% of these surgeons sought psychiatric or psychological help. That so many of those who needed help did not seek it brings a disturbing issue to light:

Doctors are concerned that seeking mental health treatment could adversely affect their medical license.  In the study, 60% of the surgeons were reluctant to seek help due to this very reason.

Surgeons who felt burned out, or reported they’d made a “major medical error” in the past 3 months, were more prone to suicidal thoughts.

Ironically, physician health may be compromised in the service of helping others to obtain better health.

According to the American Foundation for Suicide Prevention (AFSP), “Physicians die by suicide more frequently than others of their gender and age, both in the general population and other professional occupations.  On the average, death by suicide is about 70% more likely among male physicians than other professionals, and 250% to 400% higher among female physicians.”

Every year, we lose the equivalent of at least two medical school classes due to physician suicide (nearly 400 doctors, according to estimates).

How do we remove the stigma around getting help?  How do we lessen the burnout? How do we remove the fears related to licensure?

I am heartened by a variety of positive measures being taken to address these issues:

1. After several suicides occurred at Vanderbilt Medical Center, a Faculty and Physician Wellness Program was established.

2. The University of California at San Diego Medical Center instituted a Suicide Prevention-Depression Awareness Program following a series of suicides.

3. The Mayo Clinic created a Program on Physician Well-Being, which combines research, education, and the development of wellness promotion programs.

4. The Liaison Committee for Medical Education recently mandated that medical schools provide a wellness program for students; a change that came about due to recent investigations of medical student distress.

5. Researchers and physicians from around the world are collaborating to promote physician wellness.  A biennial conference on physician health brings together members from the American, Canadian and British Medical Associations.

6. The Arkansas Medical Board changed the wording on their licensure application after several suicides occurred.

7. An interventional study was conducted by Krasner and colleagues to determine the effect of a mindfulness-based program on physician well-being, burnout, and empathy towards patients. The results showed short and long-term improvement in physician well-being and attitudes associated with patient-centered care.

8. Dr. Patricia Lindholm, president of the Minnesota Medical Association has made physician wellness a top priority for her tenure.

The good news is that there is insufficient space to mention all the commendable efforts already in existence to improve physician health.

However, the work has only just begun.

If you want to heed the call to action, you can make a difference. By reaching out to a colleague in distress, supporting a wellness program, or working to reducing the stigma of mental heath issues, you may save a colleague’s life.

Heather Fork is founder and coach at the Doctor’s Crossing.

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